COVID-19 Outbreaks in Long-Term Care Continue, But Mitigation Efforts May Be Working

Outbreaks of COVID-19 have continued in long-term care facilities across the U.S., with an attendant rise in cumulative cases and deaths.

But an issue brief on the case data from the Kaiser Family Foundation (KFF) published last week also suggests that mitigation efforts might be having a positive impact on the outbreaks’ severity.

Predictably, total COVID-19 cases and deaths have increased over time, KFF found, but with some key differences across different states.

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As of August 20, the states with the highest rates of COVID-19 long-term care cases and deaths per 100,000 state residents were among those that dealt with the pandemic’s earliest peaks — both in long-term care and overall in the community.

The issue brief drew from state-reported data on COVID-19 cases and deaths in long-term care facilities.

That means states like New York, Massachusetts, and Connecticut have much higher long-term care COVID-19 cases and deaths per 100,000 residents than states where cases are still rising, Priya Chidambaram, a policy analyst at KFF, told Skilled Nursing News last week.

One possible reason for this — though she noted it remains in the realm of the speculative — is that some of the measures SNFs implemented had a positive impact.

“We can attribute that to what we know has been the biggest change in long-term care facilities over the last six months, and that’s policies around visitors, policies around testing, and isolating residents that have tested positive,” she told SNN. “There is reasonable cause to believe that some of these measures have been successful in basically making sure the spread doesn’t get worse than it was at the beginning of the pandemic.”

That said, Chidambaram noted in the briefing that it will be important to reassess long-term care cases and deaths in states were rates are still rising, such as Texas and California. But for now, they are experiencing lower rates of COVID-19 cases and deaths than states that hit their peak in March and April.

While the share of COVID-19 cases attributed to long-term care facilities has decreased over time, long-term care COVID-19 deaths have fairly consistently accounted for almost half of all such deaths, KFF found.

Long-Term Care COVID-19 Deaths As Share of Total COVID-19 Deaths
Source: Kaiser Family Foundation

The residents in any kind of long-term care facility, whether a skilled nursing facility or another kind, tend to be those with conditions that put them at higher risk for severe cases of COVID-19, Chidambaram told SNN.

In terms of how SNFs are responding, there are some key metrics KFF plans to keep an eye on, she added. These include staffing shortages, testing, and personal protective equipment (PPE) availability in long-term care facilities, according to Chidambaram.

And even though there has been some research on the characteristics of SNFs with severe outbreaks, KFF wants to learn more about kinds of facilities that have severe outbreaks — or any outbreaks of COVID-19 — and whether factors such as infection control deficiencies or ownership play a role.

KFF will also be looking at the federal COVID-19 nursing facility data, which SNFs are required to report.

“One of the things we are going to keep an eye out for is tracking how well the federal data aligns with the state-reported data,” Chidambaram told SNN. “If the federal data is reporting more new deaths and more new cases than the state-reported data, then we would definitely take a look at the federal data to see: Are states more likely to report accurate and timely data through the federal reporting mechanism then through the state reported data?”

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